Matza Louis S, Paramore Clark, Prasad Manishi
The MEDTAP Institute at UBC, 7101 Wisconsin Ave, Suite 600, Bethesda, MD 20814, USA.
Cost Eff Resour Alloc. 2005 Jun 9;3:5. doi: 10.1186/1478-7547-3-5.
Attention-deficit hyperactivity disorder (ADHD) is a common disorder that is associated with broad functional impairment among both children and adults. The purpose of this paper is to review and summarize available literature on the economic costs of ADHD, as well as potential economic benefits of treating this condition. A literature search was performed using MEDLINE to identify all published articles on the economic implications of ADHD, and authors were contacted to locate conference abstracts and articles in press that were not yet indexed. In total, 22 relevant items were located including published original studies, economic review articles, conference presentations, and reports available on the Internet. All costs were updated and presented in terms of year 2004 US dollars. A growing body of literature, primarily published in the United States, has demonstrated that ADHD places a substantial economic burden on patients, families, and third-party payers. Results of the medical cost studies consistently indicated that children with ADHD had higher annual medical costs than either matched controls (difference ranged from 503 dollars to 1,343 dollars) or non-matched controls (difference ranged from 207 dollars to 1,560 dollars) without ADHD. Two studies of adult samples found similar results, with significantly higher annual medical costs among adults with ADHD (ranging from 4,929 dollars to 5,651 dollars) than among matched controls (ranging from 1,473 dollars to 2,771 dollars). A limited number of studies have examined other economic implications of ADHD including costs to families; costs of criminality among individuals with ADHD; costs related to common psychiatric and medical comorbidities of ADHD; indirect costs associated with work loss among adults with ADHD; and costs of accidents among individuals with ADHD. Treatment cost-effectiveness studies have primarily focused on methylphenidate, which is a cost-effective treatment option with cost-effectiveness ratios ranging from 15,509 dollars to 27,766 dollars per quality-adjusted life year (QALY) gained. As new treatments are introduced it will be important to evaluate their cost-effectiveness to provide an indication of their potential value to clinicians, patients, families, and third-party payers.
注意力缺陷多动障碍（ADHD）是一种常见疾病，与儿童和成人的广泛功能损害相关。本文的目的是回顾和总结关于ADHD经济成本以及治疗该疾病潜在经济效益的现有文献。使用MEDLINE进行文献检索，以识别所有已发表的关于ADHD经济影响的文章，并联系作者查找尚未编入索引的会议摘要和即将发表的文章。总共找到了22篇相关文献，包括已发表的原创研究、经济综述文章、会议报告以及互联网上可获取的报告。所有成本均按照2004年美元进行了更新和呈现。越来越多主要在美国发表的文献表明，ADHD给患者、家庭和第三方支付者带来了巨大的经济负担。医疗成本研究结果一致表明，患有ADHD的儿童每年的医疗成本高于匹配对照组（差异范围为503美元至1343美元）或未匹配对照组（差异范围为207美元至1560美元）。两项针对成人样本的研究也发现了类似结果，患有ADHD的成年人每年的医疗成本（4929美元至5651美元）显著高于匹配对照组（1473美元至2771美元）。少数研究考察了ADHD的其他经济影响，包括家庭成本；ADHD患者的犯罪成本；与ADHD常见精神和医疗合并症相关的成本；患有ADHD的成年人因工作损失产生的间接成本；以及ADHD患者的事故成本。治疗成本效益研究主要集中在哌甲酯，这是一种具有成本效益的治疗选择，每获得一个质量调整生命年（QALY）的成本效益比在15509美元至27766美元之间。随着新治疗方法的引入，评估其成本效益对于向临床医生、患者、家庭和第三方支付者表明其潜在价值非常重要。
